Provider Demographics
NPI:1790438224
Name:SALUBRIOUS INTERNATIONAL LLC
Entity Type:Organization
Organization Name:SALUBRIOUS INTERNATIONAL LLC
Other - Org Name:SALUBRIOUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HAIR LOSS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-469-0386
Mailing Address - Street 1:PO BOX 497631
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-0122
Mailing Address - Country:US
Mailing Address - Phone:773-469-0386
Mailing Address - Fax:
Practice Address - Street 1:359 E 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-2840
Practice Address - Country:US
Practice Address - Phone:773-469-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty